Migraine Management in Older People

Migraines are a type of neurological disorder causing headaches, nausea, and lightheadedness. These headaches are often preceded by what is called an “aura.” Auras are a cluster of symptoms such as tingling in the arm or leg and visual disturbances - which alert the person that the headache is coming. The headaches are typically described as throbbing and painful, are usually located on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound.

When to Seek Immediate Help

Most headaches, including migraines, are not dangerous. Sometimes, however, headaches can be a sign of some other underlying disorder. If the person’s headache is accompanied by any of the following, he or she should seek more immediate medical attention:

Seek help if the person has:

Seizures

Very painful and/or very stiff neck

Sudden onset severe headache

Prolonged aura symptoms lasting over a few hours

New headache pain after the age of 50

Pain that is made much worse with coughing, sneezing, or other movement

Who Gets Migraines?

Women are three times more likely to get migraines than men - and most people will have their first episode in childhood or young adulthood. It is rare for migraines to start after the age of 40. Many who suffer with migraines have close relatives who also have migraines. We also know that in women, hormonal changes appear to be a strong factor during puberty, menopause, pregnancy, and the menstrual cycle.

Age appears to help ease migraines. People often see a lessening of symptoms after the age of 50. However, many over 65 still do have migraines.

Triggers and Prevention

Some things associated with migraines lead us to clues about possible prevention. We know that in many migraine sufferers, certain foods can trigger a migraine headache. One way we know this is by people keeping track of their headaches and what leads up to them.

Keep a Headache Journal

So, the first prevention recommendation is to keep a journal to keep track of things like sleep, water intake, foods, menstrual cycles, and headaches. When you start to see patterns, you can start to develop a personal list of triggers to avoid.

Avoid Common Food Triggers

While different people may have different triggers, some are very common. Aged cheese, chocolate, alcohol – especially red wine, highly caffeinated beverages, salty foods all have been reported to trigger migraines.

Avoid Stress

In multiple studies, people who are more stressed also tend to get more migraine headaches. Reduce any external pressures, time with difficult people, etc. as much as possible.

Avoid Overstimulation

Some headaches are triggered by strong smells, bright lights, and loud noises.

Exercise

Some people have reported that when they feel a headache coming on, going for a brisk walk or jog can stop the process before it becomes a throbbing headache.

Professional and Home Treatment

If you have migraines, the best course of action is to see your physician. He or she can make a diagnosis and provide you with multiple options for therapies that can help with your headaches. Some medications can have serious side effects or complications, so be sure that you ask a lot of questions about the risks and benefits of different types of medicines for migraines. For older people who may be on multiple medications, this is particularly important.

Home and Alternate Remedies

Exercise – regular exercisers may have fewer incidences of headaches

Water – adequate water intake, like the recommended 8 glasses of water a day, may help

Omega 3’s – These special fats are found in fatty fish and in flax seeds. Some research suggests it may help prevent headaches.

Stress Reducing Activities – massage, meditation and yoga may help relax you. These various forms of relaxation have promise in helping migraine sufferers

Adequate Magnesium - Eating foods rich in magnesium may help those with migraines. Foods high in magnesium are fish, leafy dark green vegetables like spinach and kale, kidney beans, oatmeal, bananas, lentils, and nuts.

Ginger – a little real ginger shaved off and added to tea or salads or soups can help with nausea associated with migraines.

Acupuncture - According to a 2006 study in the Lancet Neurology, “47 percent of participants in the traditional acupuncture group … experienced a reduction of migraine days by 50 percent or more.”

Older People and Migraines

Since older people often have more than one chronic condition and may be taking more medications, it is important to weed out cause and effect of headaches. Sometimes, medications may be actually causing the migraines as noted above. In other cases, medications may cancel out migraine medication making it ineffective. Also, certain disorders are associated with migraines, like depression. It is sometimes hard to figure out which came first or which is causing the other! It is, therefore, important to work closely with your physician to make sure that she knows about all medications and other conditions in order to not only find the likely cause, but also to know which treatments will work best. Keeping your journal over a long period of time can help sort out these issues and lead to a better understanding of the total health picture of the person.